GREATER MANCHESTER HEALTH AND SOCIAL CARE STRATEGIC PARTNERSHIP BOARD

Transcription

1 GREATER MANCHESTER HEALTH AND SOCIAL CARE STRATEGIC PARTNERSHIP BOARD Date: 25 November Subject: Report of: Implementing GM Information Management and Technology Strategy Geoff Little, Steve Wilson and Nicky O Connor PURPOSE OF THIS REPORT This report updates the Strategic Partnership Board on the progress towards the implementation phase of the GM IM&T Strategy. The GM IM&T Strategy was approved by the Strategic Partnership Board in June Following this the GM IM&T programme has taken forward two key building blocks for moving into the implementation phase for this work: Development of a GM H&SC Digital Collaborative proposal and supporting implementation governance Establishment of a delegated GM IM&T fund which will sit alongside the existing GM Transformation Fund to provide capital and revenue funding for the delivery of IM&T elements of Locality Plans and GM wide IM&T programmes and priorities RECOMMENDATIONS That the Strategic Partnership Board: Note the overall approach to implementing the GM IM&T Strategy. Agree the proposal for a GM H&SC Digital Collaborative and revised GM IM&T governance arrangements Note the progress made towards the establishment of a delegated GM IM&T fund. CONTACT OFFICER: Vicky Sharrock vicky.sharrock@nhs.net 1

2 1.0 BACKGROUND 1.1. The delivery of the GM health and social care strategic plan, Taking Charge requires significant system change. IM&T is a key enabler of our ability to change at the pace and scale GM has set out to achieve. We need to better link our organisations, improve their capacity to share relevant information safely and securely within individual localities and across the GM footprint. We need to give our frontline staff the technological tools to improve the way we work and the care we provide. Each Locality Plan across GM is dependent on IM&T transformation GM has collaborated on the development of a single GM IM&T strategy. This strategy was agreed by the GM Health and Social Care Strategic Partnership in June As well as meeting GM s requirements, this strategy also aligns to national priorities, such as the development of a Local Digital Roadmap. The GM strategy articulated the GM-wide technical architecture that GM has collectively agreed to implement, such as DataWell and GM-Connect. It also sets out technology and information developments that will be led by each locality Moving into the implementation phase requires the development of a deliverable, achievable, funded implementation plan. Work on a GM-wide implementation plan is in progress. This being developed in collaboration and will be consulted on across the system, ensuring agreement of GM and locality priorities. Across GM we have examples of excellent IM&T systems and approaches. In developing a GMwide implementation plan we will draw on this best practice and agree options for scaling up activity that works well This note sets out two key building blocks necessary to support implementation: Development of a GM Health and Social Care (H&SC) Digital Collaborative and supporting implementation governance. This will ensure we have appropriate GM-wide development and governance forums to take the collective IM&T decisions required to deliver our strategy. Establishment of a delegated GM IM&T budget. This will sit alongside the existing GM Transformation Fund to provide capital and revenue funding for the delivery of IM&T elements of Locality Plans and GM wide programmes 2.0 GM HEALTH AND SOCIAL CARE DIGITAL COLLABORATIVE 2.1. GM has a diversity of information systems and standards across its locality-based health and social care services, which share a common purpose to inform better integrated care, through the provision of the right information, about the right person, available to the right employees, at the right time IT and information teams in component organisations across GM are already overstretched meeting increasing demands, and seldom have the opportunity to work together under a common, load-sharing IM&T strategy, often as a result of capacity issues and the need to deliver against organisational priorities. 2

3 2.3. GM-wide systems to deliver a connected care system for the whole of GM have been agreed. DataWell is currently being piloted and when scaled up across GM has the potential to enable citizen data and information to flow more easily between organisations, enabling health and care colleagues to make better informed decisions with the residents they are working with. A GM-wide approach to information governance has also been agreed through the development of GM- Connect. This will ensure we have infrastructure platforms in place to securely share information across our organisational boundaries and enable citizens to take greater control of the uses of their data This GM-wide activity will support all of our localities and health and care organisations to link information, take better informed decisions and identify potential future risk. These areas of work also support the wider public service reform priorities. GM has a unique potential to link a broader range of public services that we know hold important data related to the health and wellbeing of GM residents, such as the police, fire service, housing partners and others While GM has taken some system-wide decisions on approaches to IM&T transformation such as DataWell and GM-Connect, it is clear that more could be done to increase system engagement, enable discussion on issues such as interoperability, and agree common technical standards that all GM partners can work towards. It is therefore proposed that we implement the GM HSC Digital Collaborative to: Provide the forum for agreeing GM technical standards. The common standards and technical architectures needed to deliver Health and Social Care services across GM will affect the IM&T activities of all partners; we therefore need pan-gm ways of developing our approach. To support transparent GMwide collaboration, a single body to support the development of common technical governance and alignment of systems is needed. Build GM-wide informatics capacity. Digital integration across H&SC will also provide GM with the tools to drive innovation and research. A GM wide informatics approach will have the potential to achieve excellent, integrated, direct health and social care services across GM now and in the future. Provide a single voice for GM as we engage in national debate. At present, when national plans and requirements such as the NHS Digital Transformation are launched GM does not have a single point of contact able to respond with a unified GM voice and to develop a consistent, holistic understanding of necessary changes to existing architecture. The GM HSC Digital Collaborative would provide GM with the mechanism to agree our position in response to national issues and to speak with a clear voice, informed by GM-wide debate The GM HSC Digital Collaborative would require the appropriate governance arrangements, ensuring the views of constituent members of the GMHSC Partnership are heard and operating as part of a wider GM governance system to: 3

4 Develop and agree an interoperable technical architecture for all health and social care related organisations in GM Take forward the GM level elements of the agreed GM H&SC architecture through an aligned commissioning approach and implementation plan Develop consistent standards and understanding of requirements for the locally driven elements of the agreed GM architecture Work alongside localities on their IM&T strategies and proposed technology changes to ensure alignment with the GM IM&T Strategy Have a single point of contact for H&SC IM&T related issues with national and regional organisations, responding, in consultation with wider partners with a single voice to consultations, proposals and requirements Provide a focal point for accessing and securing investment to deliver the required GM H&SC digital architecture 2.7. Establishing the GM HSC Digital Collaborative, will also generate opportunities for further collaboration and data flows across wider public services which have a huge bearing on health and well-being Appendix A contains the draft proposal for a GM HSC Digital collaborative which is focused on: Developing the technical infrastructure to enable interoperability across GM Strong links to GM-Connect as the information sharing commission for GM Having direct responsibility for the delivery of GM aspects of the IM&T strategy Maintaining strong links across localities and organisations within the GM H&SC Partnership Developing agreed GM standards 2.9. Appendix A also details proposed governance and accountability arrangements including: A GM HSC Digital Collaborative Board which will enable the setting of an agreed GM-wide strategic direction and have oversight of delivery. A GM IM&T Core Group (led by a small GM HSC Digital Collaborative team) responsible for coordinating the implementation of the agreed GM IM&T strategy and technology architecture. Thematic delivery groups for driving the implementation of the individual elements of the GM IM&T strategy 4

5 A GM IM&T Clinical/Practitioner Reference group to ensure the direction of the strategy and its implementation is clinically safe and focused on improved care provision The GM HSC Digital Board reporting into the GM Public Service Reform Board, ensuring a focus on wider integration is taken forward Membership of these groups will be agreed with GM partners, membership will be clear to all partners and papers submitted to meetings will be available to partners. All groups will have clear terms of reference and decisions will be transparent across the system, drafts of which will be circulated for comment. The terms of reference for each of the groups will identify interdependencies with other key stakeholders across GM and wider A clear communication and engagement plan will be developed for the GM HSC Digital Collaborative, building on and strengthening existing engagement that has taken place. The GM IM&T Enabler Group will discuss the GM HSC Digital Collaborative proposals over the coming months. Final proposals will therefore be informed by system-wide engagement The GM IM&T Core Group will have responsibility for operational oversight and coordination of the GM IM&T Strategy and will be chaired by a new post of Chief Digital Officer (CDO) who will work with the GM system to develop an agreed joint position on the route to implementing our IM&T strategy. The role of a GM Chief Digital Officer has been consulted on across GM and proposals amended to reflect views expressed. This role will provide the senior change management leadership required for our system. Working with colleagues from across the health and social care system in GM, the CDO would also require considerable technical experience, ensuring informed debate takes place on the varying technical options GM must consider in agreeing GM-wide work Membership for the GM IM&T Core Group will have representation from all aspects of the GM IM&T health and social care system including: Chief Information Officer and Chief Clinical Information Officer representation from across GM CCG IM&T Leads Social Care (adults and children s) representation Primary care representation NWAS representation CCG representation Leads for each thematic delivery group Programme Director for GM-Connect Chair of the IM&T Clinical /Practitioner Reference Group Community and Voluntary sector provider representation Information Governance leads for health and social care in GM, Finance representation via the Finance Executive Group (FEG) Members of the GM H&SC Partnership Team. 5

6 2.14. It is essential that, we establish capacity within the GM IM&T Core team as quickly as possible. This may mean in the short term releasing capacity from within GM whilst a recruitment process is undertaken to fill roles on a longer-term basis A GM HSC Digital Collaborative team will be established to lead the GM IM&T Core Group and deliver the responsibilities of the GM HSC Digital Collaborative. This team will need clear technical knowledge and expertise across the existing systems in use across GM health and social care along with programme management and analytical capacity. This team will include the following roles. GM H&SC Chief Digital Officer - responsible for leading the technical architecture design and oversight of its delivery. This role will be directly responsible to the Board. GM HSC Digital Collaborative Programme Manager GM HSC Digital Collaborative Business Analyst The estimated costs associated with establishing this initial team are c 300k for 6 months 2016/17. It is likely as we progress with implementation there will be further skill requirements identified. The delegated IM&T fund outlined in section 3 below may enable us to establish additional capacity within the proposed Digital Collaborative team Given the linkages between the Health and Social Care Digital Collaborative and the delivery of GM-Connect, the GM HSC Digital Collaborative Chief Digital Officer will work closely with the developing GM-Connect team and in particular their Chief Digital Officer role within the team. The GM-Connect team is currently being developed and will oversee the digital infrastructure elements of the GM-Connect programme. Both of these roles are significant and complex. Co-location (at least for part of the time) and close working will ensure they are complementary and supportive in the delivery of their responsibilities. This will also be facilitated through the proposed joint reporting arrangements between GM-Connect and the GM H&SC Digital Collaborative In addition, the GM HSC Digital Collaborative team will work closely with the NHS England GM Digital Officer, whose role is to support GM respond to national requirements and priorities. The GM HSC Digital Collaborative will also work with other national partners who are considering how the local and national parts of IM&T architecture in GM can link. The development of the GM H&SC Digital Collaborative has been welcomed by colleagues at a national level The GM IM&T thematic delivery groups will each be responsible for the implementation of one of the five elements of the GM IM&T strategy (Connect, Integrate, Collaborate, Empower, Understand). Each thematic delivery group will have: A Lead officer (chair) who will also be a member of the GM IM&T Core Group 6

7 Cross representation of ICT professionals from the GM health and social care system and partner organisations. Finance representation via the Finance Executive Group (FEG) Support from the central GMH&SC Partnership Team Representation from the GM IM&T Clinical / Practitioner Reference The GM IM&T Clinical / Practitioner Reference group will be utilised on a regular basis to provide input, recommendations and advice to the implementation work to ensure proposals for changes do not have unintended consequences for clinical safety and effectiveness. 3.0 DELEGATED GM IM&T FUND 3.1. Across GM, localities are developing business cases to access the GM Transformation Fund. GM has now made its first Transformation Fund decisions and is investing in Locality Plans that will deliver integrated care across all public sector partners within their locality footprints. The investment cases approved so far are dependent on the ability to link data and information, enabled through technology. The need for IM&T capital is therefore increasingly urgent if GM is to achieve the ambition for devolution GM has proposed the establishment of a GM delegated fund for IM&T from within the nationally available funding and is currently in discussions with national partners including NHSE on this proposal. Such a delegated fund would enable delivery of agreed GM-wide priority activity and support the implementation of the IM&T requirements of Locality Plans. To that end, clear proposals will be developed on how we collectively access and allocate the fund A national funding allocation to support IM&T activity across health and social care, was announced in late Were GM to agree a population based share of the parts of the fund focussed on driving digital locally our understanding is this could potentially equate to circa 50m capital and 23m revenue for the period 2016/ /21. Further discussions are ongoing and the final agreement will be reported to the Strategic Partnership Board. The proposal is based on a number of key principles: The GM delegated budget will enable delivery of Locality Plans. Allocations will be made based on robust business cases, aligned to the locality and GM-wide transformation plans. The GM delegated IM&T fund will use the existing governance processes in place for the GM Transformation Fund. The GM H&SC Digital Collaborative will advise on use of the delegated GM IM&T funding 7

8 Formal delegation of funding will be agreed based on a GM IM&T Delivery Plan to be agreed with the national Digital Delivery Board GM is currently working with national partners including NHS England to establish the timescales for agreeing a GM delegated fund. Subject to these ongoing discussions we are working towards agreeing a Delivery Plan and Business Case with both the GM and national governance by the end of January, leading to potential draw down of funds commencing later this financial year. 4.0 RECOMMENDATIONS The Board is recommended to: Note the overall approach to implementing the GM IM&T Strategy Approve the proposal for a GM H&SC Digital Collaborative Note the progress made towards the establishment of a delegated GM IM&T fund 8

9 Appendix A Greater Manchester Health and Social Care Digital Collaborative Draft proposal 11 November 2016

10 Contents Introduction... 2 Strategic Plan commitments... 2 Requirement for a GM H&SC Digital Collaborative... 3 Scope of the GM H&SC Digital Collaborative... 4 Roles and responsibilities... 5 Governance and Accountability:... 7 Proposed GM H&SC Digital Collaborative structure : 7 GM H&SC Digital Collaborative Board: 8 GM H&SC IM&T Core Group: 8 GM H&SC Digital Collaborative Team: 9 GM IM&T Thematic Delivery groups for each element of the GM IM&T strategy 10 GM IM&T Clinical / Practitioner Reference Group 11 GM IM&T Strategy: Principles, Programmes and Priorities Principles 11 Programmes 12 Priorities 13 1

11 Introduction The ambition across Greater Manchester is to drive system change and deliver the fastest and greatest improvement to the health and well-being of residents through the delivery of the GM strategic plan Taking Charge. This sets out a clear ambition for the next five years. GM s ability to deliver on the commitments within the strategy will be significantly impacted upon by our use of technology and information. IM&T can enable us to change the health and social care services we provide and in doing so change lives. The ability to predict and prevent need across GM, through an integrated understanding of the causes of ill-health will drive efficiency across the system as a whole. In addition to this GMs ability to see the holistic needs of individuals and their families will enable personalised packages of care and support which will in turn increase effectiveness. Empowering residents to participate in their own health and social care, changing the relationship between resident and public services, will enable individuals to stay well for longer and will drive increases in health and well-being across the whole population. A Greater Manchester Health and Social Care Digital Collaborative has the potential to act as a cornerstone to the delivery of the GM IM&T Strategy, driving benefits across the whole GM Health and Social Care system and realising the aspirations of the GM Strategic Plan. In developing the GM HSC Digital Collaborative consideration will be given to the wider public service reform and an understanding of developments already underway in other parts of the public sector in GM. Being cognisant of this will not ensure we are all working in the same direction and not creating duplication but will also unlock the potential for deeper and wider collaboration generating greater benefits for the residents of GM. Strategic Plan commitments The Greater Manchester Strategic Plan, Taking Charge of our Health and Social Care set out the ambition for Greater Manchester over the next five years. The GM Strategic Plan made specific commitments to using information and technology to: Understand citizen needs, and develop services more efficiently and effectively Ensure people have greater access, ownership and responsibility over their own data Share data and information across organisations on a daily basis to support integrated multi-agency case management Use technology to support self-management Generate multiple ways for people to interact with the health and social care system Use information more effectively across organisations Reduce duplication Ensure speedy access to the right service Work with the wider public sector on the implementation of our information sharing strategic programme GM-Connect 2

12 Shared information and the ability of all staff to understand the holistic needs and strengths of citizens and service users are fundamental to the successful delivery of this vision. Agreement to sharing information (including data gained through consent of those individuals) is key to integration at the locality and neighbourhood level, supporting people where they live. This different way of viewing information and the importance of sharing data will drive a new relationship between citizens and public services. We need to recognise this means new ways of working which our employees need to feel supported in by our collective leadership across Greater Manchester. To enable this transformation requires standards and technology to be in place across localities and GM Health and Social Care organisations with capacity to interact beyond the traditional HSC organisations. To this end GM has developed an approach to IM&T focused on delivering the commitments within the Strategic Plan. This proposed approach was signed off by the GM Strategic Partnership in June 2016 and we are now moving in to a new phase of implementation. Requirement for a GM H&SC Digital Collaborative GM has a diversity of information systems and standards across its locality-based health and social care services, which share a common purpose to inform better integrated care, through the provision of the right quality information, about the right person, available to the right employees, at the right time. IT and information teams in component organisations across GM are already over-stretched meeting increasing demands, and seldom have the opportunity to work together under a common, load-sharing IM&T strategy, often as a result of capacity issues and the need to deliver against organisational priorities. GM-wide systems such as DataWell, currently being piloted will enable citizen data and information to flow more easily between organisations. GM-wide information governance through GM-Connect will ensure we have platforms in place to securely share information across our organisational boundaries and, where appropriate, to enable citizens to take greater influence of the uses of their data. The common standards and technical architectures needed to deliver health and social care services across GM will affect the IM&T activities of all partners, yet there is currently no common technical governance body in place to align and develop those systems in a way that allows, enables and ensures connectivity. It should be noted that the development of an agreed programme of work at the Greater Manchester level including investment requirements is a significant task. This will also need to incorporate an understanding of the impact on the wider public sector system in GM and a clear risk management approach. Digital integration across H&SC will also provide GM with the tools to drive innovation and research. A GM wide informatics approach will have the potential to achieve excellent, integrated, direct health and social care services across GM now and in the future. 3

13 In addition when national plans and requirements such as the NHS Digital Transformation are launched GM does not have a single point of contact able to respond with a unified GM voice and to develop a consistent, holistic understanding of necessary changes to existing architecture. A single GM HSC Digital Collaborative, with the appropriate governance arrangements and delegated authority in place would enable GM health and social care to: Develop a consistent technical architecture for all health and social care related organisations in GM Take forward the GM level elements of the agreed GM H&SC IM&T architecture through a single commissioning approach and implementation plan Building on existing work across GM to develop consistent standards and understanding of requirements for the locally driven elements of the agreed GM architecture Advise localities on their IM&T strategies and proposed technology changes to ensure alignment with the GM IM&T Strategy Have a single point of contact for all appropriate health and social care IM&T related issues with national and regional organisations, responding, in consultation with wider partners with a single voice to consultations, proposals and requirements Provide a focal point for accessing and securing investment to deliver the required GM health and social care architecture Have a stronger position with vendors, ensuring they work together better for the wider benefit of Greater Manchester. This rest of this paper is focused on the potential establishment of a GM Health and Social Care Digital Collaborative setting out proposals for: Scope Roles and responsibilities Governance and accountability Membership In establishing a GM HSC Digital Collaborative progress is driven towards potential further collaboration and data flows across wider public services which have a huge bearing on health and well-being. Our objective should be to make significant strides towards establishing common goals and standards across the GM health and social care system and to ensure these are capable of integration with parallel activity in other parts of the GM Public Sector Reform programme and partner agencies and in doing so avoid duplication. Scope of the GM H&SC Digital Collaborative Delivering a common approach to information and technology for health and social care within GM has two separate but interdependent elements: 4

14 The information governance architecture to put in place the appropriate legal and ethical frameworks for sharing information and The technical architecture to enable interoperability across organisations at the locality and GM levels GM has already created a new data sharing commission, GM-Connect with the mandate for sharing across all public sector organisations across the conurbation. The GM HSC Digital Collaborative will not seek to replicate this, but will create strong links across to this body. Equally GM-Connect have identified GM health and social care as a key priority for implementation. The GM HSC Digital Collaborative will therefore focus on the technical architecture and architecture requirements to deliver the overall GM ambition. In doing this the GM HSC Digital Collaborative would provide technical advice and guidance on the GM level health and social care architecture requirements but also how this connects to IM&T Strategies and existing H&SC architecture at the locality level. In doing this the GM H&SC Digital Collaborative will work with partners to identify and respond to potential impacts on the wider public sector IT strategies including Local Authorities, GMP, GMFRS for example. It is proposed the GM HSC Collaborative will work towards consistency across: Acute Providers Mental Health Providers CCGs Public Health Community Health providers Primary Care (including GPs, pharmacy, optometry and dentistry) Local Authority Social Care Ambulance Trust Out of Hours Providers In developing the GM H&SC Digital Collaborative, capacity for aligning architectures across a wider range of local partners will be taken into account. This will help future proof the work of the GM H&SC Digital Collaborative, reflecting the increasing breadth of organisations providing an integrated response to health and social care challenges across our localities. The importance of this wider, medium-term capacity for alignment should be viewed as equally important to tackling the immediate challenges of our H&SC architecture. The GM H&SC Digital Collaborative will focus on the delivery of the agreed GM Health and Social Care IM&T Strategy, taking responsibility directly for delivering the GM elements of this strategy whilst developing standards for locality elements and ensuring locality IM&T strategies are aligned to the overarching GM IM&T Strategy. Roles and responsibilities The GM H&SC Digital Collaborative would be responsible for the delivery of the core elements of a technology and architecture as outlined in the GM IM&T Strategy required to achieve the 5

15 vision within the GM Strategic Plan. It would be a single point for the establishment of GM wide health and social care principles, decisions, development of standards across GM and designing solutions. It will also provide a wider co-ordination function to ensure interoperability across agencies and advise localities on connectivity between GM and localities. To do this, the GM H&SC Digital Collaborative will be responsible for: The GM H&SC IM&T Strategy and Local Digital Roadmap Development of the GM H&SC IM&T Implementation Plan, including baselining our current position and the development of specific business cases supported by investment plans for information and technology, incorporating information governance and sharing, cyber security amongst other areas of the GM architecture. Identifying opportunities, promoting and encouraging innovation across Greater Manchester to improve the maturity of the health and social care economy supporting GM-wide analytical capacity Developing a standardised and uniform approach to enabling information flows across the GM system in line with national and local requirements Setting and defining the principles, standards and policies which can then inform architectural decision making Providing oversight to ensure the GM IM&T Strategy is being delivered in a coherent way Using GM-Connect to ensure the information sharing governance and sharing frameworks are in place across Health and Social Care. Coordinating and supporting bids for national resources to ensure the largest possible proportion of available funding for GM Advising on the allocation of resources delegated to GM for IM&T to ensure the most appropriate use of available funding aligned to the GM IM&T Strategy Making recommendations on which elements of the GM IM&T Strategy should be delivered at which geographical level (GM wide, locality or cluster) and the potential for sharing services across GM Sharing knowledge across GM to ensure best practice is identified, lessons learnt and potential for wider adoption To do this the GM H&SC Digital Collaborative will need to: Design and articulate the required architecture across GM H&SC, ensuring this reflects stakeholder needs and requirements and adherence to national requirements Engage with all localities and partner organisations across GM to generate buy-in to the GM architecture and collaborative approaches to its delivery Focus on those areas of the IM&T architecture that will benefit from working at scale across Greater Manchester Provide co-ordination and coherence across various portfolios of work, building on existing GM architecture and best practice Ensure the GM design architecture is updated and in keeping with the latest requirements of reform and developments in technology 6

16 Hold GM organisations to account for the delivery of the locality and organisational based aspects of the GM IM&T strategy Ensuring national standards are incorporated into the GM IM&T Strategy Ensure alignment between local, regional and national initiatives Ensure alignment and interoperability between organisations in GM within localities and across locality and organisational boundaries Manage risks associated with the delivery of a GM H&SC technology architecture Define a consistent set of principles to be used in commissioning IM&T Develop an outcomes based IT and Informatics Commissioning Framework for GM that will support collaborative activity Ensure all IM&T commissioning activity is aligned to agreed GM standards and the overall GM strategy for information and technology. The GM H&SC Digital Collaborative will work closely with GM-Connect who will provide the information sharing capability and capacity and bolster the capacity of health and social care in Greater Manchester. Governance and Accountability: The GM H&SC Digital Collaborative would be responsible to both the GM H&SC and broader GM Public Sector Reform governance. It would therefore link in to the GM H&SC Strategic Partnership Board and its Executive and the GM Reform Board. It would make use of the existing cross-sector governance arrangements around GM-Connect for information governance and sharing. Currently there are a range of IM&T groups across GM, many established prior to the GM H&SC Partnership and GM Strategic Plan. In establishing the GM H&SC Digital Collaborative, a thorough review of all existing IM&T governance forums should be undertaken, ensuring that revised arrangements are both fit for purpose and as streamlined as possible. Proposed GM H&SC Digital Collaborative structure : The GM H&SC Digital Collaborative proposed structure would consist of: A GM H&SC Digital Collaborative who will oversee the delivery of the agreed GM IM&T Strategy. A GM IM&T Core Group (led by a GM H&SC Digital Collaborative team) responsible for coordinating the implementation of the agreed IM&T strategy and technology architecture. GM IM&T Thematic Delivery groups for driving the delivery of the individual elements of the GM IM&T strategy A GM IM&T Clinical / Practitioner Reference group to ensure the direction of the strategy and its implementation is clinically safe and focused on improved care provision Reporting arrangement into the GM Public Sector Reform Board, ensuring a focus on wider integration is taken forward. Locality governance would be clearly linked into these structures through representation on the Core Group and the individual implementation groups. The various elements of the H&SC 7

17 system in GM would be represented on the governance groups and would have responsibility for ensuring the views of localities influence the decision making processes, development and adoption of GM standards. The diagram in Annex A outlines this proposed structure In taking this work forward the GM H&SC Digital Collaborative will continue to work with the national and regional IM&T teams within NHS England, NHS Digital and NHS Improvement. GM H&SC Digital Collaborative Board: The GM HSC Digital Collaborative Board will provide strategic direction, leadership and oversight for the implementation of the GM IM&T strategy and its membership would have senior level representation from across the whole health and social system, partners and links to the existing GM-Connect Governance. Board members will: Provide clarity and guidance to the GM HSC Digital Collaborative on business needs (information sharing and otherwise) needs of their domain / stakeholder group. Be mindful of changes and impacts elsewhere Ensure operational input is provided Own the resolution / mitigation of risks and issues that are relevant to their business area and to take action to resolve interdependencies with other activities Support wider interoperability and champion why it is going to be required Manage local escalation of risks and issues as necessary Provide constructive challenge back in terms of delivery and benefits realisation Support wider governance processes such as solutions design and Make timely decisions and take appropriate actions, so as not to hold up initiatives, programmes or projects Delegate responsibility to the Digital Collaborative team where necessary and appropriate to ensure pace if maintained. GM H&SC IM&T Core Group: The GM IM&T Core Group will have responsibility for operational oversight and coordination of the GM IM&T Strategy and will be chaired by new GM Chief Digital Officer who will work with the GM system to develop an agreed joint position on the route to implementing our IM&T strategy. The role of a GM Chief Digital Officer has been consulted on across GM and proposals amended to reflect views expressed. It is anticipated that this role would provide the senior change management leadership required for our system. The role would also require considerable technical experience, ensuring informed debate takes place on the varying technical options GM must consider in agreeing GM-wide work. Membership for the GM IM&T Core Group will have IM&T representation from all aspects of the GM H&SC system to include: 8

18 Chief Information Officer and Chief Clinical Information Officer representation from across GM CCG IM&T leads Social Care (adults and children s) representation Primary care representation NWAS representation Leads for each GM IM&T thematic delivery groups, Community and Voluntary sector provider representation Programme Director for GM-Connect, Chair of the GM IM&T Clinical / Practitioner Reference Group, Information Governance lead for H&SC in GM, Finance Leads Members of the GM H&SC Partnership Team. In identifying the membership of the GM IM&T Core Group it is essential to ensure all aspects of the health and social care system in GM is represented, where this doesn t occur through the above roles specific representation will be sought from suitable individuals. GM H&SC Digital Collaborative Team: To deliver the responsibilities of the GM H&SC Digital Collaborative, the team will need to have clear technical knowledge and expertise across the various systems already in use across the health and social care system in GM and the ability to understand how new technologies and systems could be implemented in order to make a step change in delivering the GM ambition. The GM H&SC Digital Collaborative will also need to have programme management and analytical capacity to be able to develop a clear understanding of the current position across GM, drive the GM level elements of the architecture, support localities deliver their elements of the architecture and manage the benefit realisation process. It is anticipated the initial resource requirements for the team will include three roles as highlighted below. These roles will be funded through the GM Transformation Fund. The ongoing negotiations with NHS England on a GM IM&T fund may enable us to strengthen these roles with additional resources. GM H&SC Chief Digital Officer (1 FTE) responsible for leading the technical architecture design and oversight of its deliver. This role will also be directly responsible to the Board and will lead the governance arrangements put in place to support the wider IM&T agenda. The GM H&SC Chief Digital Officer will link to the GM-Connect leadership to ensure the information governance requirements of the programme are met. Programme Manager (1FTE) - responsible for the overall programme management of the GM Implementation Plan to achieve the GM architecture. This will include direct management of the GM elements of this programme of activity and working with localities and organisations across GM to ensure the locality elements are being 9

19 delivered. The role will manage the risk profile for all aspects of the programme and is responsible for ensuring the Board and wider governance groups are updated on progress, enabling them to take necessary decisions. Business Analyst (1FTE) responsible for understanding current position across GM and levels of digital maturity. In addition this role will work with localities to identify the potential benefits through the implementation of the GM Strategy and architecture and manage the benefits realisation process. Detailed role profiles for each of the identified roles above will need to be developed and should be aligned to similar GM roles within for example the GMHSC Partnership and the GM- Connect team. The estimated costs associated with establishing this initial small team are c 300k for 6 months 2016/17. The team will need to work with the GM IM&T leads from across all GM H&SC organisations. This will be essential to building buy-in across GM and ensuring the GM H&SC Digital Collaborative capitalises on the collective expertise from across the GM system. The Team will also share progress through the governance groups which will be reviewed as part of the establishment of the GM H&SC Digital Collaborative. Given the linkages between the GM H&SC Digital Collaborative and the delivery of GM- Connect, the GM H&SC Digital Collaborative Chief Digital Officer will work closely with the developing GM-Connect team and in particular their Chief Digital Officer role, which is currently being developed and will oversee the digital infrastructure elements of the GM- Connect programme. Both of these roles are significant and complex, co-location (at least for part of the time) and close working will however ensure they are complementary and supportive in the delivery of their responsibilities. This will also be facilitated through the proposed joint reporting arrangements between GM-Connect and the GM H&SC Digital Collaborative In addition, the GM HSC Digital Collaborative team will work closely with the NHSE GM Digital Officer, whose role is to support GM respond to national requirements and priorities. The GM HSC Digital Collaborative will also work with other national partners who are considering how the local and national parts of our IM&T architecture can link. GM IM&T Thematic Delivery groups for each element of the GM IM&T strategy These groups will each be responsible for the delivery of one of the five elements of the GM IM&T strategy (Connect, Integrate, Collaborate, Empower, Understand). The membership of these groups will vary to match the delivery requirement of each specific theme. In principle however each group will include: A Lead officer who will also be a member of the GM IM&T Core Group Cross representation of ICT professionals from the GM H&SC and partner organisations. Representation from the GM IM&T Clinical / Practitioner Reference Group Finance representation Support from the GM H&SC Partnership Team 10

20 The membership of these groups will come through the networks of individuals across the health and social care. It is essential that all organisations across GM recognise the importance of enabling officers to be part of these groups, where necessary through releasing their capacity to deliver time bound pieces of work. Clear links to locality IM&T groups will also be needed. GM IM&T Clinical / Practitioner Reference Group This group will provide clinical input to the development and implementation of the various aspects of the GM IM&T strategy. The group will be used on a regular basis to provide input to the implementation work and to ensure proposals / changes do not have unintended consequences for clinical safety and effectiveness. In addition members of the clinical reference group will be aligned to the delivery groups to ensure a clinical perspective is fed directly into their activity. GM IM&T Strategy: Principles, Programmes and Priorities Principles The GM Information Management and Technology strategy is focused around five key principles: Empower: Citizen empowerment increased use of technology assisted care services including text, secure messaging and video conferencing. Development of single patient portal across GM giving citizens the ability to view and permit access to their own health and social care data. Connect: Connectivity anywhere expansion of existing wireless network across all health and social care locations and reduction in duplication across network architecture Foundation architecture consolidation/federation of directories across GM, supporting the ability to share; the adoption and expansion of virtual architecture; expanding the use of communication and messaging technologies amongst organisations and care professionals. Integrate: 11

21 Electronic shared record shared GM record across all organisations to support accuracy in service provision and reduce risk including GP, acute, community, mental health and third sector information supported by the creation of a GM wide master patient index GM information governance and approach to sharing to enable the right information, in the right place at the right time Electronic records GM wide digitisations; expansion of electronic referral and booking systems to standardise and simplify patient flows and expansion of electronic document sharing to allow correspondence to be shared across organisations Consolidated applications creation of an architecture that allows for shared Picture Archiving and Communication System across GM and shared pathology results with central storage Standards adoption standard referral pathways, shared and consistent alerts and reporting and agreed consistent language across all organisations. Collaborate: Consolidated IM&T services creation of merged teams across skill areas and applications Optimise organisations consistent and collaborative procurement, asset and resource optimisation Understand: GM wide data analysis working across GM with joint datasets to understand population level requirements and to support analysis by wider organisations with GM based research. This GM level analysis will also enable how we commission services in the future and needs therefore to be built on quality data and consistent standards. Programmes The diagram below outlines how the full range of elements of the GM IM&T Strategy come together to create an ambitious potential architecture. 12

22 Collaboration/Consolidation GM Standards/Quality Common Governance Information Standards Directory of Services GM CONNECT Information Sharing & Governance GM Wide Health and Social Care Single View of the Resident Research And Development Shared Analytics Common Citizen Portal Governance Layer Technology Enabled Care Services/Inter net of things Secure Messaging Digital Referral Pathways Consolidated Applications Consolidated IM&T Services Shared Clinical Services Record Digitisation Expansion of Existing Systems Shared Resource Optimisation Single Shared PACS/VNA SPINE Integration Shared/ Interoperable Electronic Records Software & Services Layer GM Master Person Index Licencing GM Unified Communications (VOIP/Presence/Video) Federated Active Directory Wifi/Free Wifi Disaster Recovery Business Continuity Cloud Data Security Compute BYOD Storage Connectivity Anywhere Server Desktop/ Virtual Desktop Collaboration Tools Data Centre Transport & Core Services Layer Health and Social Care resilient network Over time there is an ambition for convergence towards interconnectivity across systems or commonality where appropriate across GM and in doing so providing consistent user experience, single services, standards and pathways. It should be recognised however that this will take time, with some organisations across GM able to move towards an agreed GM architecture sooner than others based on their current position. This direction will deliver significant benefits for GM wider than driving service improvements, increasing our ability to attract investment, improving system wide knowledge and therefore increasing opportunities for innovation, academic and clinical research in collaboration with industry Priorities To make progress on the application of the above principles, the priorities are: GM-Wide information and technology architecture to enable collaboration GM-Connect and DataWell are key elements of the proposed GM IM&T architecture. GM-Connect will delivery GM wide information sharing and governance, whilst DataWell has the capacity to provide the a single resident view at point of care, acting as an information broker across the complex and varied landscape we currently have in place across GM. 13

23 Development of integrated, place-based information and technology systems Supporting implementation of locality care organisations and the delivery of their wider locality plan priorities. This area of work will seek to bring all organisations in GM up to a minimum digital maturity and in doing so enable all localities to be part of the wider GM architecture outlined above. Support the wider systems required to underpin all aspects of the GM IM&T strategy There are a host of technology and information support systems required to deliver the GM IM&T Strategy. Effective data security, effective WiFi, collaboration tools and appropriate data storage and server facilities for example will improve our ability to provide effective IM&T support across GM. Accelerate the implementation of digitally based applications that deliver step improvements in productivity in the processes of care. Annex A: Governance proposal for delivering GM Health and Social Care IM&T Strategy GM IM&T Strategy Implementation Governance Structure Greater Manchester Combined Authority GM HSC Strategic Partnership Board GM Reform Board GM HSC Strategic Partnership Board Executive GM HSC Transformation Portfolio Board GM-Connect Executive Steering Group GM IM&T collaboration and coordination functions GM Health & Social Care Digital Collaborative Board GM Wide information sharing exchange capability GM-Connect Leadership Group GM Health and Social Care IM&T Core Group GM IM&T Clinical / Practitioner Reference Group IM&T Connect Delivery Group IM&T Integrate Delivery Group IM&T Collaborate Delivery Group IM&T Empower Delivery Group IM&T Understand Delivery Group Locality based IM&T governance and implementation groups 14